Avatar Contraception Communication Training

Official title

Improving Clinician Communication About Contraception Using Teen and Parent Avatars

Overview

In order to support the desire of most adolescents to delay pregnancy (parenting) until their own adulthood, pediatricians must be comfortable and skilled in having reproductive health conversations with adolescents and the mothers of adolescents. Advocates for Youth (AFY), a national, youth-facing, well-established, non-profit, is known for innovative sexual and reproductive health programs. AFY successfully implemented a virtual simulation for schoolteachers to practice sex education scenarios by interacting with culturally diverse student avatars. We will partner with AFY to adapt their novel simulation-based approach to train medical residents in using SDM with youth and parent avatars. Our long-term goal is to build clinician confidence in SDM and actual skills via simulation training with dyadic avatars. We will also explore how evaluation of clinician communication skills varies from youth-, parent-, and clinician-viewpoints.

Detailed description

Specific Aims seek to (1) iteratively adapt and refine the simulation training (1a) and measurement tools (1b) with three community advisory boards (CAB) of separate groups of teens, parents, and clinicians; and (2) conduct a proof-of-concept pre-post evaluation of clinician confidence in counseling dyads after one-time exposure to the simulation (n=100 medical residents). We will record residents' communications in the simulation and a subset of clinicians, parents, and adolescents from each CAB will evaluate residents' SDM skills via the Person-Centered Contraception Counseling (PCCC) scale. Hypothesis: Most medical residents (75%) will self-report improvement or stability in confidence with high acceptability of the simulation training. We will explore 1) overall concordance between self- and expert-reported evaluation outcomes (SDM skills, PCCC scale); 2) compare the distribution of each evaluation item by evaluator; and 3) explore correlations between scales by evaluator. Impact: This proof-of-concept study, co-developed and co-evaluated with community members and families, fills a gap in communication training to inform a future fully powered ORBIT stage 3 efficacy trial to test actual triadic communication in the real-world with comparator groups of medical residents across national training programs.

Interventions

• Behavioral avatar communication training
  Avatar simulates a mother and a daughter for the pediatrician to practice communication about contraception.

Primary outcome measures

• Questionnaire [Time frame: Change from baseline (T0) at 0 hours, and end of training (T2) at 2 hours]

Secondary outcome measures (3)

• Acceptability Questionnaire [Time frame: At end of study (T2) at 2-hours]
• Questionnaire [Time frame: Change from start (T1) at 20 minute to end of training (T2) at 2 hours]
• Questionnaire [Time frame: Change from start (T1) at 20 minute to end of training (T2) at 2 hours]

Eligibility criteria

Inclusion Criteria (providers):

• Providers (medical residents, fellows, attendings)
• Recruited from the Adolescent and Young Adult (AYA) Medicine Clinic at Children\'s Medical Center of Dallas.

Exclusion criteria

• Unable to speak or read in Spanish/English

Criteria are shown verbatim from the registry (in English). Final eligibility is always assessed by the study center.

Healthy volunteers: Yes

Study design

Allocation

N/A

Model

Single group

Masking

Open label

Primary purpose

Health services research

Study locations

United States · 2 centers

• Childrens Health Adolescent and Young Adult Medicine (AYA) Clinic — Dallas
• UT Southwestern Medical Center — Dallas

Identifiers

NCT: NCT05995574 · Pending funding

Primary sources (government registries)

• ClinicalTrials.gov (US NIH)

View this study on ClinicalTrials.gov ↗